This morning I began my usual morning routine. I am an early riser. I open my laptop, check my phone for messages, begin sorting out emails to respond to, and begin my workday. But this morning marks a day on my calendar I never forget, or more appropriately, always remember. December 1, 2014, I was sitting on a gurney being marked up for my DIEP flap breast reconstruction. Writing about my DIEP flap breast reconstruction seven years later? How is that possible? Where did the time go?
The Days and Months Leading up to my DIEP Flap
My coffee is fresh and warm and my thoughts flood through my mind as I recall the events of the morning I showed up at the hospital. Yes, I showed up. But boy did that take a lot of decision making, planning, and a strong dose of physical and emotional fortitude in the days leading up to my breast reconstruction. What I felt most confident in the day I showed up for surgery, was the skill of my surgeon. To put trust in a human being’s hands who was about to cut a swath of tissue and blood vessels from your lower abdomen, transplant it to my chest wall to recreate new breasts, yes, that took trust.
How did I establish belief and confidence in Dr. C? Months of research. I had time, energy, and drive to execute a plan. My double mastectomy was complete. Recovery from this breast surgery gave me time to do my homework and find the best possible microsurgeon I felt I could trust. I looked at his curriculum vitae, years of experience, success rate, and the members of his surgical team who would be working with him the day of my DIEP flap.
Where the rubber hit the road, the day I met him face to face. I felt most comfortable meeting him in person since I was a delayed DIEP flap, a patient with prior radiation, and a patient who had a successful skin sparing, nipple sparing mastectomy. In my mind, I had baggage. After leaving the consult that day, I realized I was likely a routine case for this skilled surgeon. He never displayed arrogance. Dr. C demonstrated confidence, knowledge, and the ability to engage in what I now know as a shared decision-making conversation regarding my desire to have DIEP flap.
The Morning of my DIEP Flap Surgery
How is it seven years later you remember in such great detail the events of a day in your life? When this day on the calendar rolls around, somedays it feels like yesterday, other days, it feels like a lifetime ago. And yet, these are the memories remaining so fresh in my mind.
I made a poster before I left home and carried it with me in my suitcase for the morning of my surgery. The title of patient advocate was something I wasn’t aware of on December 1, 2014. The blog I write and nonprofit Foundation I opened to support others going through what I was about to experience was not on my radar as I sat on the gurney prepared to go to surgery.
Why did I bring that silly poster? I had no idea, seriously no idea. Perhaps I had a premonition my life was going to drastically change after my DIEP flap. I also sensed Dr. C was a man of good humor and would likely not balk at such antics, even when I asked him to put on a blue cap in solidarity for this picture.
The Patient is Prepped and Ready to go Back
The purple pen came out of his pocket, and he began marking me up. Light strokes of the surgical pen on the canvas of his day’s work marked the areas he would be repairing and putting me back together after the ravages of breast cancer, radiation, and surgery spending hours under a high-powered microscope or surgical loupes. Shortly after all protocols were completed, IVs placed, discussion with the anesthesiologist, instructions from the nurses for my husband during the day, off I went down the corridor to the surgical theater for my long winter’s nap. Meanwhile, my parents, husband, two sons, sisters, nieces, nephews, and friends waited for the news I was awake and back in my room. This is something few understand but the patient themselves, the burden of others’ emotions and care. It is heavy and real and comes with a great deal of gratitude as well.
What I Know Now and Have Learned Since My DIEP Flap Seven Years Ago
For all intents and purposes, my DIEP flap results, and recovery were seamless, beautiful, and life changing. That silly poster I brought into the surgical ward the morning of my DIEP flap was a sign in the literal and figurative sense. It meant a great deal Dr. C had the sense of humor to oblige a photo with me. However, it was figuratively a sign of things to come.
What I know now is not everyone has the fortune I experienced for my DIEP flap. There are times it feels our bodies betray us. Risks of surgeries, explained to us during a consult with hopes they never happen, do happen. I did not have wound issues, seromas, nausea after waking, financial or insurance constraints to deal with, a plastic surgeon who talked down to me or did not give me all my options, or worse, flap failure. Other patients have experienced these events. The poster was a sign of things to come for me.
It was my destiny to be a patient advocate for those who followed my decision to pursue reconstruction. My life was etched in stone the morning of my DIEP flap. My new purposeful life was placed before me to listen to others’ experience, concerns, answer questions, provide support, collaborate with other advocates, surgeons, and health care professionals to help guide those affected by breast cancer through their own personal Journeys. I stand on the shoulder of giants that include patients, caregivers, and all those who work with patients before, during, and after their breast reconstruction.
Seven Years After My DIEP Flap Breast Reconstruction, “How Does that Make you Feel?”
I sent a private message to Dr. C this morning on the seventh anniversary of my DIEP flap reminding him he was marking me up in the surgical ward seven years ago. His response, “Wow! How does that make you feel?”
My response: “Grateful you are in my life and my body did its thing to accept all the challenges of this decision to do DIEP.” It is an honor to collaborate with him now informing patients what to expect for this surgery, and how to become empowered through shared decision-making.
Hello. I enjoyed reading about your journey & congratulations on being a survivor 🙌🏼 & glory be to God. I had Diep flap done in 2016. Do you know if insurance is required to pay for more reconstruction 6 years after the original reconstruction?
Thank you so much for your kind comments Teresa! You ask a very good question and only the provider or surgeon’s office will be able to answer this for you. It will depend on how it can be coded. If it involves more symmetry, you had prior radiation, and a other considerations may all be part of their ability to have insurance cover further reconstruction. I wish I could answer this more directly, but again, it really depends on the provider combined with the type of insurance you have. Be well and best wishes! ~ Terri
Hi Terri, I will be undergoing DIEP Flap Reconstruction in two weeks. I found out in October that the cancer I thought was behind me after 11 years had reared its ugly head. It’s on the same side as last time. My options are mastectomy or mastectomy with reconstruction. I have opted to have double mastectomy with reconstruction, mostly because I don’t want to have to deal with it ever again. But now, I find myself thinking and rethinking, questioning my choice. The numbness I have read about is a bit disturbing. Do one or both, if I do just one, at least I will have some feeling in one side. It’s exhausting. I keep praying about it, leaving it only to pick it up again. I wish it were behind me so I could get on with it. I’ve had too much time to think. I’m praying my experience is as seamless as yours.
Hello Linda. Yes, this can be an exhaustive decision process. The days leading up to surgery seem to ramp up the emotions and all you have been through. My hope is your surgeon does nerve reconstruction. I had this successfully performed and from your comments, perhaps you have read the blog on this or listened to the podcast on the podcast tab about nerve preservation and reconstruction. Not all microsugeons perform this procedure. Those that do, it does take time for nerves to grow back. For me, it was around a year. I wish you comfort and care during your reconstructive decision process and hope all goes smoothly for you. Thanks for reaching out and for your comment. ~ Terri